SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER (NPI# 1386107746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386107746 |
| Entity Type | Organization |
| Organization Name | SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER |
| Practice Address |
8555 Taft St Merrillville IN 46410-6123 |
| Mailing Address |
8400 Louisiana St Merrillville IN 46410-6385 |
| Practice Telephone | 2197694005 |
| Practice Fax Number | 2197571950 |
| Mailing Telephone | 2197571939 |
| Mailing Fax Number | 2197571950 |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2019-04-11 |
| Authorized Official Name | MRS. JUDITH K SIKORA (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2197571921 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHLAKE COMMUNITY MENTAL HEALTH CNTR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100157670 | 05 |
| Other Name | Type Code |
|---|---|
| Regional Mental Health Centers | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902043672 | Southlake Community Mental Health Center | Clinic/Center | 8555 Taft St, Merrillville, IN 46410-6123 | 2009-01-16 |
| 1811134588 | Southlake Community Mental Health Center | Non-emergency Medical Transport (VAN) | 8555 Taft St, Merrillville, IN 46410-6123 | 2009-01-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER INC | 8555 Taft Street, Merrillville, IN 46410 |
| Street Address |
8555 TAFT ST |
| City | MERRILLVILLE |
| State | IN |
| Zip Code | 46410-6123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114927142 | Jose Lorenzo Ramirez | Psychiatry & Neurology | 8555 Taft St, Merrillville, IN 46410 | 2005-08-01 |
| 1669098471 | Lucy Chavez-reyes | Registered Nurse | 8555 Taft St, Merrillville, IN 46410-6123 | 2020-06-18 |
| 1972126019 | Jennifer Vega | Registered Nurse | 8555 Taft St, Merrillville, IN 46410-6123 | 2020-05-23 |
| 1043832280 | Christine M Juda | Registered Nurse | 8555 Taft St, Merrillville, IN 46410-6123 | 2020-05-11 |
| 1881227650 | Deidre Blackwell | Counselor | 8555 Taft St, Merrillville, IN 46410-6123 | 2020-02-19 |
| 1316582018 | Ameer Elsalaymeh | Counselor | 8555 Taft St, Merrillville, IN 46410-6123 | 2019-11-18 |
| 1548816077 | Nora Alfonsi | Dietitian, Registered | 8555 Taft St, Merrillville, IN 46410-6123 | 2019-08-12 |
| 1932752573 | Eric B Jimenez | Counselor | 8555 Taft St, Merrillville, IN 46410-6123 | 2019-07-23 |
| 1265084859 | Shawn Smith | Nurse Practitioner | 8555 Taft St, Merrillville, IN 46410-6123 | 2019-07-12 |
| 1194382929 | Vincent Liszewski | Registered Nurse | 8555 Taft St, Merrillville, IN 46410-6123 | 2019-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023636867 | Lena Danielle Clouse | Pharmacist | Genoa Healthcare LLC, 8555 Taft Street, Merrillville, IN 46410 | 2020-07-08 |
| 1134752728 | All In One Therapy, LLC | Speech-Language Pathologist | 1800 W 84th Drive, Merrillville, IN 46410 | 2020-02-21 |
| 1134759335 | David John Kujawa | Social Worker | 8398 Mississippi St., Merrillville, IN 46410 | 2020-01-16 |
| 1619513603 | Activate Healthcare - Plumbers Local 210 Clinic | Clinic/Center | 2905 E 83rd Place, Merrillville, IN 46410 | 2019-11-25 |
| 1568946994 | Larry Smith | Case Manager/Care Coordinator | 233 E 83, Merrillville, IN 46410 | 2018-09-21 |
| 1114401536 | The Sheet People | Durable Medical Equipment & Medical Supplies | 8874 Louisiana Street, Merrillville, IN 46410 | 2018-09-21 |
| 1659858439 | Heather Grinder | Hearing Instrument Specialist | 9120 Connecticut Dr., Suite C, Merrillville, IN 46410 | 2018-07-24 |
| 1710463872 | Mitchell G Smith | Optometrist | 1601 E 81st Ave, Merrillville, IN 46410 | 2018-07-12 |
| 1336631753 | Nwi Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 1454 E. 86th Place, Merrillville, IN 46410 | 2018-06-01 |
| 1659860427 | Wendell B Fleming | Counselor | 230 West 175th Place, Apartment I, Merrillville, IN 46410 | 2018-05-07 |
| Find all providers in zip 46410 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558856542 | Concept Therapy Professional Corporation | Clinic/Center | 3110 Old Us 20 W, Elkhart, IN 46514-1168 | 2018-06-22 |
| 1518256684 | Therakids Potential | Clinic/Center | 130 N West St, Crown Point, IN 46307-3916 | 2011-03-29 |
| 1760449441 | Therapies In Motion Inc | Clinic/Center | 359 East Morgan, Martinsville, IN 46151-1681 | 2006-04-27 |
| 1558847087 | Healing Hands Outpatient Therapy and Rehabilitation Center LLC | Clinic/Center | 216 E 9th St, Anderson, IN 46016 | 2018-07-18 |
| 1235593278 | Turnstone Center for Children and Adults With Disabilities, Inc. | Clinic/Center | 3320 N Clinton St, Fort Wayne, IN 46805-1918 | 2016-04-06 |
| 1689016776 | South Indy Mri and Rehab Services | Clinic/Center | 8141 S Emerson Ave, Suite A, Indianapolis, IN 46237-8560 | 2013-07-18 |
| 1972855336 | Comfort Healthcare Therapy LLC | Clinic/Center | 714 W 53rd St, Anderson, IN 46013-1514 | 2012-10-10 |
| 1316271992 | Healing Hands Therapy | Clinic/Center | 2017 W Franklin St, Evansville, IN 47712-5112 | 2009-09-29 |
| 1780864926 | Shadeland Anesthesia | Clinic/Center | 8805 N Meridian St, Indianapolis, IN 46260-2760 | 2007-11-05 |
| 1568689818 | Jackson Center for Conductive Education Inc | Clinic/Center | 802 N Samuel Moore Pkwy, Mooresville, IN 46158-1467 | 2007-04-19 |
| Find all providers with the same taxonomy | ||||
| City | MERRILLVILLE |
| Zip Code | 46410 |
Please comment or provide details below to improve the information on SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.